Abstract
The clinical results after total hip replacements using noncemented stems have shown considerable variability over the years; the design and characteristics of the implant seemed to play a role in explaining this fact. The purpose of this paper is to report the clinical, radiographic and densitometry results of total hip arthroplasties using a stem designed for noncemented implantation and to engage and load the femur proximally. Fifty-eight consecutive patients (62 hips) followed for an average of 4.3 years (range 36-70 months) were clinically and radiographically followed up at three weeks, three months, six months, one year, and yearly thereafter. The average pre-operative Harris hip score was 49 increasing to 98 at the latest follow-up. There were no cases of aseptic or septic loosening. The average subsidence at three years was 0.45 mm (SD +/- 0.36 mm). Radiographically all hips were classified as stable, and evident changes compatible with new bone apposition were observed in 64% of the cases. The extended proximal geometry of the device seems to favour initial and secondary stability as reflected by the low subsidence values over time. The maintenance of periprosthetic bone stock and the absence of stress shielding can be explained by the predominantly proximal loading pattern of the stem.